Nurses play a major role in ethics regarding evidence implementation and generation. Nurses need to have some regard as to what is right and what is wrong within different contexts. If a nurse is a part of a research project, you can’t just pull information from Wikipedia, the nurse must be able to determine what sources are and are not ethical to use. For example, if there is a research article regarding birth defects in fish, we can’t go ahead and apply it to humans. Nurses must have some ethical regard as to what research can be used to implement and generate information regarding a research question. Nurses contribute to the ethical conduct of research and implantation of research findings by apply their knowledge regarding proper research techniques. By following the proper criteria and using judgement, a nurse can conduct a proper investigation for the research findings. I guess I’m not completely sure if I’m perceiving this question correctly but will learn from the CITI models how a nurse should properly act in their role of evidence implementation and generation.
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Before starting our research, I knew that birth control was correlated with the formation of blood clots but I was unsure as to why or how. As 4 women in this class, we chose this topic because we felt like it effected all of us. When we began to dive into our PICOT question, looking at the research, we discovered that there was much about birth control that we didn’t know. Our research has thought us that the use of combined oral contraceptives increases someone’s risk in developing blood clots. This risk though is effected by what hormones are used, how many, pregnancy, and any history of developing clots (MI, stroke, PE). I guess I could say that my appraisal and synthesis has changed by assumptions, but I didn’t have many assumptions to begin with. I feel like my assumption is just reinforced. Through my appraisal and synthesis, I feel like I’ve learned a lot regarding hormonal birth control and it will positively impact my future role as a nurse. I can now educate patients more effectively about the negative effects of birth control. Specifically, I can provide better teaching for those with a history of blood clots, educating them on risks and which birth controls have the lowest risk. My team members and I have reached the same conclusion I believe. I say this based off our conversations about the topic and our new understanding of it. Team SeaDogs has worked well together so far. The biggest issue I’ve seen is finding the time and place to meet up together. Half the group lives in Portland, with one member not driving, another in Biddeford, and I live in Auburn. I’ve found that not having class during our schedule time helps with this as we all have that block of time free. Another challenge that we have faced is fully understanding what the assignment is asking of us. Some are stronger writers than others, so sometimes it takes us a moment to make sure we are all on the same page with an assignment.
(5) Explain the importance of managing medication information to the patient when he or she is discharged from the hospital or at the end of an outpatient encounter:
So many medications come with adverse effects and drug-to-drug interactions. Performing a medication reconciliation prior to discharge is so important. It can help prevent drug interactions and can prevent the same drug from being prescribed twice. When someone is discharge, it’s important to get a gauge on their knowledge of their medications. It’s important patients know how to take, when to take, and where to store their medications in order to receive the proper effect. I learned the importance of managing medication information when interviewing my friend for this assignment. I had realized the dangers of not knowing proper administration and dosage of medications. In todays society, we feel very comfortable taking over the counter meds and often don’t realize they come with adverse reactions just like our prescriptions. By making sure a patient is on the same page as their provide, in regard to medications, it can help promote healthy patient outcomes. Managing medication information can also identify any potential problems. For example a patient could be taking an OTC drug that interacts with a prescription they received in their hospital stay. By providing proper medication education prior to discharge, we can ensure patient safety.
Throughout these past few weeks my team, the Seadogs, have changed our PICOT question once. We did this so we can widen our search because we were having a difficult time finding articles that fit our question. I think our topic was a bit too specific and it made it very difficult to find articles that fit all aspects of our question. Our PICOT now is, “what is the effect of hormonal contraceptives on risk of thromboembolism formation?”. Before we had a small age range (15-30) and were comparing specific birth controls; pill and copper IUD. Personally, my biggest challenge has been getting into the habit of looking at all aspects of the article. I used to find a research article and not worry about if it was primary, secondary, or a review. Each one of us in the group struggled with finding adequate articles. I’d say it has been the weakest point of team Seadog’s so far.
Although we had our struggles, the biggest success in my team is our ability to be flexible and work with one another. We are all so willing to listen when someone has a suggestion. We also all put in our input before reaching a decision. At times, not all of us understood the assignment. We would be patient with one another and explain it. I think our open communication has allowed us to move forward past our mistakes and will allow us to be successful with this assignment.
For our topic, my group has decided to focus on how women ages 15-30 risks for developing blood clots are effected by their usage of either birth control pills or non-hormonal IUDs. So far, we have a good team dynamic of coming together to get the work done. We plan on meeting either between classes or during the schedule time for our EBP class. We will hold one another accountable by asking one’s thoughts and contributions for this paper. We will choose dates and times that allows everyone to attend that way no one person is doing more work than another. If a team member isn’t participating as much as they should then I think our communication skills are good enough with one another that we can discuss why that person isn’t doing as much as they should. Since we have already picked a topic that is an interest for us all I don’t see a major disagreement coming up but if one does then we will use a democratic approach to solve it. A benefit about working as a team is the variety of perspectives that will be coming into forming this paper. Just in our discussion about our topic so many different questions arise that we wanted to look further into. A barrier that we might encounter would be the lack of literature on our topic.
I came into this program with a very open mind as to what specialty I want to consider for a future career. I’m in the stage of ruling out things I know I don’t want to do rather than picking a specific one. I do have 3 specialties that I’ve been thinking about since applying to school; public health, pediatrics and critical care. Through courses in college I grew an interest in public health and was very excited to find out that becoming a public health nurse is an option for me. With Pediatrics, I’ve always loved working with children. I feel very comfortable communicating with them and I love making them laugh. As for critical care this is something that I never really considered until I started nursing school. My grandmother became ill back in March and I spent many hours in the ICU visiting and getting to see how things go over those 8 weeks. She recently passed and how those nurses treated her and our family was so great that I think it might be something I want to do in my future.
Before looking over our books and other course content I had no idea what type of class I was coming into. When I first heard of evidence-based practice I just figured we would be learning how to properly look up things we needed to learn about or improve. In a way this is correct, there is much more than goes behind EBP. I assumed it would be a far lengthy process because I was thinking of it more as research. I was a biology major prior to this so it was all I knew. I am looking forward to learning throughout this semester because I believe it will give me the tools I need to be a successful nurse. Nurses need to think on the fly and be creative. Learning more about how to apply research, EBP, and quality improvement within the clinical setting will make both my future patients and team have more successful outcomes. The knowledge I will gain from this course will help me work through my nursing process in clinical this summer.
I think that the stigma behind mental illness is driven by our societal norms and how we believe we should behave and act. Those with mental illnesses are often seen as weak and/or unstable. There are many factors that affect mental illnesses like age, gender, and culture. I believe that in our society we don’t want to share our stories of mental illness because we are afraid of being judged by others. As I’ve grown older I’ve found that the stigma associated with mental illness has begun to subside but it is still very present. Self- stigma is influenced by your community, your support system, and social media. I’ve found that social media makes me often compare myself to others and influences me into believing that I should behave, look, and feel a certain way.
Culture is something that heavily affects how someone perceives mental illness. Some areas don’t have the resources or education to properly help those with mental illnesses. Someone’s culture might also change how someone talks about mental illness with a provider. How they perceive their symptoms or how they think they should feel will affect their response. Someone might think that the way they feel or are behaving is normal when it isn’t. Religion also affects how someone may perceive mental illness because it often outlines how someone should or shouldn’t feel. For example, someone who is believes in heaven might not understand why someone has become depressed over the death of a loved one. An example that I’ve seen within my culture is LGBTQ individuals, who also practice religions such as Christianity, who believe that their feelings regarding their sexuality and/or gender is wrong.
How I made a difference
Reflecting on my clinical experience this semester I’ve realized how much I’ve learned. From my first to my last clinical I grew in confidence. The process of gaining this confidence came through many patient interactions. When thinking of how I made a difference, I can think of one patient interaction I had with a woman on week two of clinical. Per our routine, we were sent off to follow our nurse for a few hours. Within those hours, we were assigned a patient and had to perform a bedside assessment on them. Typically, these assessments take about 15 minutes but that day it took me over an hour and a half.
I began my assessment by following the flow of the clinical paperwork in front of me. With every question I asked she would give me a lengthy response that gave me insight on her life. I really remember when I asked about her diet and if she was tolerating it. She went on to tell me about all the things she would cook for herself throughout the day. I got to learn all about her family and even her past marriages. When she was telling me about her cooking she went on to mention that one of her husbands was Greek and he would cook her all types of Greek food. Not only did she tell me about the foods he would make for her but she would tell me about all the Greek weddings she got to attend. I made a comment to her asking, “did you and your husband ever get to break the plate?” She quickly responded with “oh honey we did more than break the plate”. We both chuckled and I went on finishing my assessment continuing making conversation with her.
When I finished up my assessment I finished with asking her if she needed anything. I went on to say how it was lovely meeting her and thanked her for letting me practice my new nursing skills on her. She then thanked me for taking my time to listen to her. She went on talking about how lonely it is being hospitalized during times like these. It had been weeks since the last time she had seen her grandchildren so she really enjoyed getting to talk about them with someone. At first our conversations were nothing more than an assessment to me. I then realized how conversing with someone can really impact their day. This made me realize how much a difference I can make with conversations.
Knowledge and Judgment
In this module I learned a few different things. I first learned that urinary retention is an adverse side affect of morphine. It also reiterated that using q.d isn’t allowed anymore. It’s helpful because it’s something we still see so it’s a useful reminder to not do it. I also learned that dimpling of the skin on the breasts could be a sign of cancer. This module got me excited for my future classes as I have so much to learn.
Priority Setting
In this module it really ingrained into my head what I can do on my own as a nurse verse what I can do with an order as a nurse. I found myself often wanting to chose the answer that I would expect to be the outcome, but had to realize I couldn’t do that without an additional step prior. So using that thinking helped me to determine what could actually be done first by me as a nurse. This module also made me realize how important it is to initiate those first steps and their role in how the scenario will play out. I also learned what the word malaise means.
Hello!
My name is Madison DeRosa and I’m an accelerated Nursing student at the University of New England. I will be graduating in May of 2022 in hopes of pursuing a career in maternal health. My first degree was in Medical Biology and I earned this at UNE as well. During this time I got to study abroad in Morocco and I got to shadow a nurse at a local clinic and this is where I found my passion for nursing.
Since high school I’ve known the medical field is where I wanted to be. I’ve also always had an interest in maternal/ child health. Having clinical on an L&D unit solidified that this was my passion and this is where I want to be.
When I’m not in school, I enjoy spending my time outdoors, crafting, or hanging with my friends. I look forward to entering the nursing field and pursuing my dreams. I love how diverse every nursing career is and how there is so much opportunity to grow.
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